RE: RE: RE: RE: RE: RE: RE: RE: RE: Pharma or SuppWell, it was a big deal with Esperion because nobody thought it could be done. Esperion's dosing with apao-1 was orders of magnitude above the circulating increases that are seen here. Keep in mind that most of the plaque is found within the artery wall. It's not the obstruction of flow that is the issue. Yes, that can cause ischemia but most heart attacks are caused by a rupture of the plaque and subsequent clot/ thrombus formation. Inflammation is believed to be the mediator for plaque rupture. There is not a strong correlation between vessel diameter and plaque which is vulnerable to rupture which is why they are using IVUS and not just angiography/ FFR. I would rather see OCT data than IVUS data to tease out a stronger response not only on plaque volume but stabilization of plaque. Also keep in mind that even if you reduce plaque in the artery wall, you will not get an increase in lumen diameter due to vessel remodeling. So its really hard for me to put a value on plaque regression if it's not tied to a reduction in clinical events. The inflammation effect is more exciting to me as I think it has more clinical value. If they could show a reduction in events following MI, this is a multi billion dollar drug. Without that, it still has value for sure, but it's really hard to put a realistic discounted number around that. I guess that's why we do the trials though!